Organization
BLACK HILLS REGIONAL EYE INSTITUTE, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI L ANDERSON CPA (CHIEF FINANCIAL OFFICER)
(605) 341-2000
Entity
Organization
Contact information
Practice address
3100 WEST LAKEWOOD ROAD, SUITE 2, GILLETTE, WY 82718-4135
(307) 686-0883
Mailing address
2800 3RD ST, RAPID CITY, SD 57701-7374
(605) 341-2000
(605) 719-3211
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116328700
—
WY
Enumeration date
10/23/2007
Last updated
05/24/2021
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